{$form.javascript}
<form {$form.attributes}>
{$form.hidden}
<input type="hidden" name="formSubmitted" value="0">
<table width="100%" border="0" cellspacing="0" cellpadding="4" class="form" id="searchForm">
  <tbody>
    <tr class="search">
	  <td width="20%">{$form.Department_Country_ID.label}</td>
      <td width="30%">{$form.Department_Country_ID.html}</td>
      <td width="20%">{t}District{/t}</td>
      <td width="30%"><select name="Department_State_ID"
            id="state" class="searchField" ><option value="0">Aucune</option></select>
      </td>
    </tr>
    <tr class="search">
      <td>{$form.Department_Name.label}</td>
      <td>{$form.Department_Name.html}</td>
	  <td>{$form.Department_Number.label}</td>
      <td>{$form.Department_Number.html}</td>
    </tr>
  </tbody>
  <tfoot>
    <tr>
      <td align="right" colspan="4">
      <input name="ok" type="submit" value="{t}Save{/t}" id="ok" class="button"
       onClick="javascript:DepartmentAddEdit.formSubmitted.value=1" />
      &nbsp;&nbsp;&nbsp;
      <input value="{t}Back{/t}" type="button"
        onClick="window.location='CountryCityList.php'"  id="cancel" name="cancel" class="Button" />
	  &nbsp;&nbsp;&nbsp;&nbsp;
	  </td>
    </tr>
  </tfoot>
</table>
</form>